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Behavioral Medicine > Drugs of Abuse 1 > Flashcards

Drugs of Abuse 1 Flashcards

1
Q

Positive reinforcement pathway can drugs of abuse involves the ______

A

Ventral tegmental area

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2
Q

During drug withdrawal dopamine levels decrease and patients develop ______.

A

depression

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3
Q

Respiratory depression happens in _____ OD.

A

heroin

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4
Q

What is the antidote for acetaminophen overdose?

A

Glutathione precursor

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5
Q

Drug abuse maintains and sustaines the ______ pathway

A

positive reinforcement

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6
Q

Describe the domapmine reward pathway in regards to drugs of abuse.

A

stimulate the ventral tegmental area → dopamine producing neurons are stimulated→ activation of the mesolimbic dopamine system.

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7
Q

Drug withdrawal (acute abstinence) is associated with _____. Long-term chronic abstinance is associated with ______.

A
  • Withdrawal syndrome
  • Craving
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8
Q

Chronic drugged state (drug-taking) leads to tolerance & dependence. What are the adaptive changes?

A

increases adenylyl cyclase and dopamine transporters

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9
Q

Drugs of abuse cause addiction which leads to abuse, _______ (2),

A

dependence and tolerance

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10
Q

Define pharmacokinetic tolerance

A

Metabolic tolerance: Stimulation of metabolism allows for increased drug elimination with long-term use.

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11
Q

Define pharmacodynamic tolerance

A

Cellular tolerance: biochemical adaptation-changes in NT levels and receptor numbers and activity.

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12
Q

EtOH facilitates the action of ____ and inhibits activation of _____receptors.

A
  • GABA
  • NMDA
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13
Q

EtOH causes which physiological reactions: slurred speech, unsteady gait/coordination, _______ (5)

A
  1. Decrease cognition
  2. Decrease myocardial contractility
  3. Vascular smooth muscle relaxation
  4. Nystagmus
  5. Mood changes
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14
Q

Tolerance of EtOH develops due to _____ (2).

A
  1. CNS adaptation
  2. increase rate of ethanol metabolism
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15
Q

Cross-tolerance of EtOH to which 2 sedative hypnotic drugs?

A

BZD & barbituates

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16
Q

EtOH can lead to gut wall inflammation, bleeding, scarring as well as pancreatitis, peripheral neuropathy, ________ (4).

A
  1. Wernicke-korsakoff syndrome
  2. Gynecomastia
  3. Testicular atrophy
  4. Edema
17
Q

EtOH inhibits ______ leading to hypoglycemia.

A

gluconeogenesis

18
Q

Alcohol withdrawal symptoms include insomnia, tremor, _______ (4).

A
  1. Tachycardia
  2. Seizures
  3. Delusions
  4. Hypertension
19
Q

Fetal alcohol syndrome can lead to intrauterine growth retardation, ______ (3).

A
  1. Microcephaly
  2. Growth deficiency
  3. Under development of the mid face

(facial abnormalities associated with heavy consumption during the first trimester)

20
Q

In fetal alcohol syndrome alcohol and fatty acids are synthesized to ______, which ends up in the newborns meconium.

A

Fatty acid ethyl esters (FAEEs)

21
Q

What is the most common clinical feature of newborns with fetal alcohol syndrome?

A

Microcephaly

22
Q

What level of alcohol will cause:

  • Emesis and stupor?
  • Coma?
  • Death?
A
  • 300 micrograms/dL
  • 300-400 micrograms/dL
  • >500 microgram/dL
23
Q

_____(alcoholism tx) inhibits acetaldehyde dehydrogenase.

A

Disulfiram

24
Q

______(alcoholism tx) lowers activity of receptors for glutamate → maintenance of abstinence

A

Acamprosate

25
Q

______ for alcohol withdrawal to prevent delirium or seizures.

A

Benzodiazepines

26
Q

_______ for alcohol withdrawal to reduce tremors and reduction of heart rate and blood pressure

A

Propranolol

27
Q

Cocaine is metabolized by plasma_____.

A

cholinesterases

28
Q

Source of cocaine:

A

Leaves of erythroxylon coca

29
Q

Physical forms of cocaine

A
  • Hydrochloride salts
  • Freebase
30
Q

Which physical form of cocaine can be taken IV or intranasally?

A
  • hydrochloride salt
  • powdered
31
Q

Cocaine mechanism of action

A
  • Blocks dopamine transporter
  • Blocks NE and serotonin re-uptake

(Rapidly absorbed, metabolized and eliminated)

32
Q

______ is the metabolite that ends up in urine of a cocaine user.

A

Benzoylecgonine

33
Q

The physical effects of cocaine are increase energy, decrease appetite, _____ (6).

A
  1. CNS stimulation (alertness)
  2. Dilated pupils
  3. Heart stim: (Tachycardia, arrhythmias)
  4. Increased BP (constriction of blood vessels)
  5. Increase temperature
  6. Euphoria or agitation
34
Q

What are the signs and symptoms of a cocaine user (6)?

A
  1. Chronically inflammed runny nose
  2. Irritation of the nasal septum
  3. Loss of smell sensation
  4. Nosebleeds
  5. Dysphagia
  6. Hoarseness
35
Q
  • Ingested cocaine→ _____ (physical symptoms)
  • IV users→______ (physical symptoms)
A
  • severe bowel gangrene
  • allergic reactions

(Lack of appetite, weight loss and malnourishment)

36
Q

Maternal complications of cocaine use (4)

A
  1. Malignant hypertension
  2. Cardiac ischemia
  3. Cerebral infarction
  4. Sudden death
37
Q

Fetal effects of maternal cocaine use?

A
  1. Spontaneous abortion and death
  2. High risk of premature rupture of membranes, preterm labor and delivery, IUGR, abruptio placentae
38
Q

Effects of maternal cocaine use on newborns?

A
  1. Cognitive and neurobehavioral problems
  2. Visual problems
  3. Suckling problems
  4. Irritability
  5. Tremors
  6. Lack of coordination

Behavioral Medicine (35 decks)

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